Measuring confrontation during recovery from addiction

The effect of confrontation on recovery from addiction continues to be a topic of considerable debate. Although many residential treatment programs view some form of confrontation as an integral part of recovery, a number of studies have found confrontation from professional treatment staff to be counterproductive. One of the problems inherent in the current debates about confrontation is the lack of a comprehensive measure of confrontation that assesses different dimensions. This study describes the development of the "Alcohol and Drug Confrontation Subscale" (ADCS), a 72-item instrument designed to measure the quantity and frequency of confrontation that individuals receive about drug or alcohol use-related problems. Confrontation is defined as an individual being told "bad things" might happen to them if they do not make changes to address a drug or alcohol use-related problem or make changes to maintain sobriety. The instrument also measures the respondents' perceptions about their relationships with confronters (three-item alpha = .79) and perceptions about the confrontational statements (three-item alpha = .63). The sample included 108 individuals entering three sober living housing organizations in Northern California between 2003 and 2005. They indicated that receiving confrontational statements about alcohol or drug use-related problems was common, especially from spouses/significant others (56% of those with significant others) and family members (60%). Participants who reported receiving more confrontation reported having more positive views about their relationships with confronters and about confrontational statements than those who received less confrontation. Additional studies are necessary to establish validity, generalize results to more diverse populations, and assess confrontation at different time points during recovery.